Martha J Mance, NURSE PRACTITIONER

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN00199 Issued in RI

Practice address

100 Highland Ave Ste 302
Providence, RI 02906-2753

Phone

(401) 633-1100

Fax

(401) 633-0047

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1083811376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHADOWBROOK LN",
            "city": "SOUTH EASTON",
            "state": "MA",
            "postal_code": "023751078",
            "telephone_number": "508-230-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE STE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062753",
            "telephone_number": "401-633-1100",
            "fax_number": "401-633-0047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122 x1216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCE",
        "first_name": "MARTHA",
        "middle_name": "J",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN00199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwyneth Maloy, MD
• Janyia K Maloy
• Mama Leonas Perinatal Care
• Lala Mammadova
• Athena Jane Manatis-Lornell
• Amy E Manchester, M.A. CCC-SLP
• Sean Manchester, L.I.C.S.W.
• Susan Manchester, RD, LDN, CNSD
• Jacqueline Mancini Geer, MA, CAGS, CRC
• Nickolas Mancini, MD

• Pediatric Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.